Comparison of Modified Meek Technique with Standard Mesh Method in Patients with Third Degree Burns

Abstract

BACKGROUND Covering burn wounds, especially high surface area burns has been always a challenge for surgeons. The Meek technique has been introduced to increase the covering area. There is paucity of clinical trials comparing the Meek technique and mesh in the same individuals to assess it efficacy. METHODS In a case-control study, 20 patients with grade III burns who underwent the Meek technique and mesh in different areas/limbs were enrolled. Expansion rate, re-epithelization, operation time, wound infection, graft failure, etc. were compared between the two groups. RESULTS Among patients, 18 were males and 2 were females. The mean of total body surface area (TBSA) was 36.9±16.6%. Mean time of re-epithelialization in the Meek group was 2.8±2.5 months and in the mesh group was 5.0±2.1 months ( p =0.01). Operation time was shorter in modified Meek technique ( p =0.04). Expansion ratio was higher in modified Meek technique ( p =0.04). Local wound infection rates were slightly different without a statistically significant difference. CONCLUSION Meek technique provided higher surface area coverage in comparison to mesh; in addition to faster re-epithelization. Therefore, it is recommended to consider the Meek technique as a routine procedure, especially those with high surface area burns.

Historical Evolution of Skin Grafting—A Journey through Time

“…The micro grafts allow a shorter duration and more uniform epithelialization than other techniques. Another benefit is the easy application compared to the difficult handling of higher expanded mesh grafts (1:6 or 1:9) [ 42 , 43 , 44 , 45 , 46 ]. In shortage of donor sites, Meek enabled the expansion of smaller grafts, as well the usage of donor sites, which cannot be grabbed by other grafting techniques [ 46 , 47 ].…”

“…In shortage of donor sites, Meek enabled the expansion of smaller grafts, as well the usage of donor sites, which cannot be grabbed by other grafting techniques [ 46 , 47 ]. Furthermore, the re-epithelialization time seems to be shorter with the Meek technique compared to mesh grafts [ 43 ]. Some graft takes failed by contamination, but these were mostly restricted to a partial area without affecting nearby skin islands [ 42 , 48 ], while the observed total take rate with Meek grafts was described by several authors between 82.3% and 90% [ 42 , 44 , 45 , 48 , 49 , 50 ].…”

Expansion of Fibroblast Cell Sheets Using a Modified MEEK Micrografting Technique for Wound Healing Applications

“…However, the mesh with expansion ratios above 1:6 was shown to be impractical, delaying the re-epithelialization process 10 . Due to the limited expansion ratio of skin graft meshing, a new technique, called MEEK Micrografting, was introduced 11,12 . This technique can enlarge the original skin graft (42 Î 42 mm 2 ) by several expansion ratios: 1:3, 1:4, 1:6 and 1:9.…”

“…The MEEK expansion ratios of 1:4-1:9 are predominantly used to treat severe burn injury, providing a high re-epithelialization rate in patients either with or without diabetic conditions in addition to reducing mortality and hospitalization 10,16−18 . Also, patients who received MEEK treatment have statistically low evidence of graft rejection or contamination because the skin graft lacks the skin tissue connection between skin lands 12,13 .…”

Underestimated Craniomaxillofacial Fractures Due to Firework

“…Facial trauma causes irreparable damage to the patient, which can lead to long-term physical and mental problems 3 . Burn traumas are also one of the most important causes of mortality (5% or more of the total number of hospital patients) 4 . In general, the craniomaxillofacial (CMF) trauma occurs following a wide variety of traumas.…”